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Professional Trainer Application If you are interested in becoming a Certified Xtreme Lashes® Trainer, please fill out the following application. Xtreme Lashes® maintains the highest standards and we seek only the most proficient, committed and enthusiastic trainers worldwide. If you have successfully completed our Level One Training, have been Certified by Xtreme Lashes® and believe you have what it takes to join our team, please completely fill out the following application. * Indicates Required Fields General Information Name:   * Address Line 1:   * Address Line 2:  City:   * State:  - Select A State/Province - USA -- ALASKA USA -- ALABAMA USA -- American Samoa USA -- ARKANSAS USA -- ARIZONA USA -- CALIFORNIA USA -- COLORADO USA -- CONNECTICUT USA -- DIS OF COLUMBIA USA -- DELAWARE USA -- FLORIDA USA -- GEORGIA USA -- Guam USA -- HAWAII USA -- IOWA USA -- IDAHO USA -- ILLINOIS USA -- INDIANA USA -- Johnston Atoll USA -- Kingman Reef USA -- KANSAS USA -- KENTUCKY USA -- LOUISIANA USA -- MASSACHUSETTS USA -- MARYLAND USA -- MAINE USA -- MICHIGAN USA -- Midway Islands USA -- MINNESOTA USA -- MISSOURI USA -- MISSISSIPPI USA -- MONTANA USA -- Navassa Island USA -- NORTH CAROLINA USA -- NORTH DAKOTA USA -- NEBRASKA USA -- NEW HAMPSHIRE USA -- NEW JERSEY USA -- NEW MEXICO USA -- Northern Mariana Islands USA -- NEVADA USA -- NEW YORK USA -- OHIO USA -- OKLAHOMA USA -- OREGON USA -- PENNSYLVANIA USA -- Palmyra Atoll USA -- PUERTO RICO USA -- RHODE ISLAND USA -- SOUTH CAROLINA USA -- SOUTH DAKOTA USA -- TENNESSEE USA -- TEXAS USA -- U.S. Virgin Islands USA -- UTAH USA -- VIRGINIA USA -- VERMONT USA -- WASHINGTON USA -- Wake Island USA -- WISCONSIN USA -- WEST VIRGINIA USA -- WYOMING CANADA -- Alberta CANADA -- British Columbia CANADA -- Manitoba CANADA -- New Brunswick CANADA -- Newfoundland & Labrador CANADA -- Nova Scotia CANADA -- Northwest Territories CANADA -- Nunavut CANADA -- Ontario CANADA -- Prince Edward Island CANADA -- Quebec CANADA -- Saskatchewan CANADA -- Yukon  * Zip Code:   * Phone:    * Alternate Phone:        Fax Number:        Email:   * Business Information Business Name:    Address Line 1:    Address Line 2:  City:    State:  - Select A State/Province - USA -- ALASKA USA -- ALABAMA USA -- American Samoa USA -- ARKANSAS USA -- ARIZONA USA -- CALIFORNIA USA -- COLORADO USA -- CONNECTICUT USA -- DIS OF COLUMBIA USA -- DELAWARE USA -- FLORIDA USA -- GEORGIA USA -- Guam USA -- HAWAII USA -- IOWA USA -- IDAHO USA -- ILLINOIS USA -- INDIANA USA -- Johnston Atoll USA -- Kingman Reef USA -- KANSAS USA -- KENTUCKY USA -- LOUISIANA USA -- MASSACHUSETTS USA -- MARYLAND USA -- MAINE USA -- MICHIGAN USA -- Midway Islands USA -- MINNESOTA USA -- MISSOURI USA -- MISSISSIPPI USA -- MONTANA USA -- Navassa Island USA -- NORTH CAROLINA USA -- NORTH DAKOTA USA -- NEBRASKA USA -- NEW HAMPSHIRE USA -- NEW JERSEY USA -- NEW MEXICO USA -- Northern Mariana Islands USA -- NEVADA USA -- NEW YORK USA -- OHIO USA -- OKLAHOMA USA -- OREGON USA -- PENNSYLVANIA USA -- Palmyra Atoll USA -- PUERTO RICO USA -- RHODE ISLAND USA -- SOUTH CAROLINA USA -- SOUTH DAKOTA USA -- TENNESSEE USA -- TEXAS USA -- U.S. Virgin Islands USA -- UTAH USA -- VIRGINIA USA -- VERMONT USA -- WASHINGTON USA -- Wake Island USA -- WISCONSIN USA -- WEST VIRGINIA USA -- WYOMING CANADA -- Alberta CANADA -- British Columbia CANADA -- Manitoba CANADA -- New Brunswick CANADA -- Newfoundland & Labrador CANADA -- Nova Scotia CANADA -- Northwest Territories CANADA -- Nunavut CANADA -- Ontario CANADA -- Prince Edward Island CANADA -- Quebec CANADA -- Saskatchewan CANADA -- Yukon   Zip Code:    Phone:     Services Offered:   * Would you be able to conduct on-site training workshops at your company facility?    If not, do you have access to another facility such as a banquet hall, hotel conference room, etc?    How long have you been employed with this company?    Best Time To Contact You:   Day   Evening Background Information Are you currently applying eyelash extensions?   Yes   No * If you answered yes, please answer all the questions in blue: How many months/years of experience do you have?  Approximately how many Eyelash Extension procedures have you completed?  How did you learn the procedure: Xtreme Lashes® workshop (date & location):  Other Company:  Other:  List all eyelash extension brands you have used or are currently using:  Degrees, Licenses and Certifications you have:  Please provide a brief bio of yourself:  Additional skills or talents we should consider:  Technical Questions (Answer to the best of your ability) 1. On average how many lashes do you apply per eye?   * 2. Approximately how long does it take to complete an eyelash extensions application?  * Other Comments / Questions:  Thank you for your interest in joining the Xtreme Lashes® network of professionals trainers. An Xtreme Lashes® representative will contact you as soon as possible. Please note: Due to increasingly aggressive spam filtering, some emails are being blocked. If you do not hear from us in a reasonable amount of time, please call us by phone at 281-907-0689 ext. 235 or email us from an alternate email address.

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